Provider Demographics
NPI:1174672786
Name:SALAMA, MAHMOUD M (DDS)
Entity type:Individual
Prefix:DR
First Name:MAHMOUD
Middle Name:M
Last Name:SALAMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9060 ACORN RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5414
Mailing Address - Country:US
Mailing Address - Phone:916-684-9950
Mailing Address - Fax:
Practice Address - Street 1:4401 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2511
Practice Address - Country:US
Practice Address - Phone:916-428-4000
Practice Address - Fax:916-393-8145
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48369122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist